Shaker Saher B, Dirksen Asger, Bach Karen S, Mortensen Jann
Department of Respiratory Medicine, Gentofte University Hospital, Hellerup, Denmark.
COPD. 2007 Jun;4(2):143-61. doi: 10.1080/15412550701341277.
Chronic obstructive pulmonary disease (COPD) is divided into pulmonary emphysema and chronic bronchitis (CB). Emphysema is defined patho-anatomically as "permanent enlargement of airspaces distal to the terminal bronchiole, accompanied by the destruction of their walls, and without obvious fibrosis" (1). These lesions are readily identified and quantitated using computed tomography (CT), whereas the accompanying hyperinflation is best detected on plain chest X-ray, especially in advanced disease. The diagnosis of CB is clinical and relies on the presence of productive cough for 3 months in 2 or more successive years. The pathological changes of mucosal inflammation and bronchial wall thickening have been more difficult to identify with available imaging techniques. However, recent studies using Multi-detector row CT (MDCT) reported more reproducible assessment of air wall thickening.
慢性阻塞性肺疾病（COPD）分为肺气肿和慢性支气管炎（CB）。肺气肿在病理解剖学上被定义为“终末细支气管远端气腔的永久性扩大，伴有其壁的破坏，且无明显纤维化”（1）。这些病变使用计算机断层扫描（CT）很容易识别和定量，而伴随的肺过度充气在胸部平片上最易检测到，尤其是在晚期疾病中。CB的诊断基于临床，依赖于连续2年或更长时间每年有3个月的咳痰。黏膜炎症和支气管壁增厚的病理变化一直难以用现有的成像技术识别。然而，最近使用多排探测器CT（MDCT）的研究报告了对气道壁增厚更具可重复性的评估。
